Provider Demographics
NPI:1114616737
Name:EARLEY, AUDREY (DOULA)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:EARLEY
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:AUDIE
Other - Middle Name:
Other - Last Name:EARLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOULA
Mailing Address - Street 1:924 ENCINITAS BLVD APT 56
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5393
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15644 POMERADO RD STE 302
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2455
Practice Address - Country:US
Practice Address - Phone:858-278-2930
Practice Address - Fax:858-278-2943
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula